McLeod J G, Walsh J C, Prineas J W, Pollard J D
J Neurol Sci. 1976 Feb;27(2):145-62. doi: 10.1016/0022-510x(76)90057-5.
Fifty patients with acute idiopathic polyneuritis have been studied clinically and electromyographically, and sural nerve biopsy was performed on 8 patients. Motor and sensory conduction studies were within the normal range in 7 patients (14%), and there was pronounced slowing of motor conduction in 25 patients (50%). There was no apparent correlation between the degree of conduction, and the clinical disability of the patient or the duration of the acute illness. Eighteen patients were re-examined at intervals up to 5 1/2 years after the onset of their illness. Eight patients (44%) were clinically normal at follow-up examination and 4 patients (22%) had a significant disability. There was no relationship between the clinical disability at follow-up examination and the results of initial or final nerve conduction studies. Electromyographic evidence of denervation, however, may indicate that complete clinical recovery will not occur. Segmental demyelination was the primary pathological change found in sural nerve biopsies and there was a significant reduction in the density of myelinated fibres in 2 nerves. It is suggested that a subacute onset of the illness,electromyographic evidence of denervation or gross slowing of conduction, and significant reduction of numbers of myelinated fibres or onion-bulb formation on sural nerve biopsy are factors which may indicate a prolonged course of the illness or incomplete recovery.
对50例急性特发性多发性神经炎患者进行了临床和肌电图研究，并对其中8例患者进行了腓肠神经活检。7例患者（14%）的运动和感觉传导研究结果在正常范围内，25例患者（50%）存在明显的运动传导减慢。传导程度与患者的临床残疾程度或急性疾病持续时间之间无明显相关性。18例患者在发病后长达5年半的时间里进行了定期复查。8例患者（44%）在随访检查时临床症状正常，4例患者（22%）有明显残疾。随访检查时的临床残疾情况与初始或最终神经传导研究结果之间无关联。然而，失神经的肌电图证据可能表明无法实现完全的临床恢复。节段性脱髓鞘是腓肠神经活检中发现的主要病理变化，2条神经中髓鞘化纤维密度显著降低。提示疾病亚急性起病、失神经的肌电图证据或传导明显减慢，以及腓肠神经活检中髓鞘化纤维数量显著减少或洋葱球形成，这些因素可能表明疾病病程延长或恢复不完全。
